Medical guidewires are commonly used for a variety of medical procedures. Such procedures include angioplasty, stenting, pacemaker insertion, electrophysiology studies, atherectomy, and thrombolysis and other coronary and peripheral endovascular procedures, and in endourology and therapeutic endoscopy of the gastrointestinal system. To position a guidewire at a desired location within a patient a medical professional navigates the guidewire through the patient's anatomy by manipulating the guidewire. Such manipulation includes advancing of the guidewire into a patient's vasculature or other portion of the patient's body while torqueing (i.e., twisting or rotating) the guidewire. Torqueing the guidewire allows the medical professional to change the spatial orientation of the tip of the guidewire when negotiating turns and branches in the patient's vasculature or other relevant portion of the patient's anatomy.
To manipulate the guidewire, medical professionals have traditionally used torque devices that securely grasp the guidewire to ease manipulation of the guidewire, but such devices typically require constant repositioning. For example, as a guidewire is advanced into the patient's body, the distance between the patient's body and the torque device decreases. When the proximity between the patient's body and the torque device decreases to the point that no further advancement is possible or difficult, repositioning is required. Typically, this involves the medical professional loosening the torque device, repositioning the torque device proximally along the guidewire to provide an additional length of guidewire between the patient's body and the torque device, and then retightening of the torque device to secure its position along the length of the guidewire. The process of loosening and repositioning the torque device may be repeated several times during the placement of the guidewire in to the patient.
Commercially-available torque devices typically require a two-handed operation to properly reposition the torque device. However, due to the complexities of some guidewire placement procedures, it may be inconvenient or even impractical for a practitioner to utilize both hands to reposition the torque device along the length of the guidewire. For example, if guidewire placement is critical, it may be undesirable to allow the guidewire to lie unheld during the repositioning procedure. As a result, additional care and attention may be required when manipulating the torque device relative to the guidewire during the procedure. This can lengthen the amount of time and the degree of difficulty necessary to complete the guidewire placement procedure.
An additional complexity with conventional torque devices is that their operation is typically not intuitive, leading to misuse of the torque device and inadvertent damage to the guidewire. Thus, some torque devices can require specialized training to facilitate proper usage of the device, yet still not avoid inadvertent misuse of the device during the course of the procedure. Additionally, some devices do not provide adequate gripping of the guidewire as may be required to push the guidewire through a vascular lesion or other guidewire path occlusion. Where an occlusion is encountered, the practitioner may overtighten the device in a manner that causes damage to the guidewire.